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Health care workers benefited from secondary prevention program to treat hand eczema

A secondary prevention program for health care workers with mild to moderate hand eczema improved severity and quality of life and positively impacted self-evaluated severity and skin protective behavior, according to study results.

Researchers in Denmark studied 255 health care workers with self-reported hand eczema within the previous year. Workers were randomly assigned to an intervention group (n=123; median age, 45 years; 95% women) or control group (n=132; median age, 43 years; 90% women). Intervention participants received skin care education and individual counseling based on patch and prick testing, and assessment of work- and domestic-related exposures. Controls received usual treatment.

Clinical severity of disease at 5-month follow-up was measured by an eczema index score and served as primary outcome. Scores on dermatology life quality index, self-evaluated severity of hand eczema, skin protective behaviors and knowledge of hand eczema from onset of follow-up were secondary outcomes.

Follow-up data were available for 247 (97%) participants. Intervention group workers displayed significantly lower scores on hand eczema severity index compared with controls, with difference of means: unadjusted –3.56 (95% CI, –4.92 to –2.14) and adjusted –3.47 (95% CI, –4.80 to –2.14), both P<.001 for difference. The intervention group also had a significantly lower (improved) mean score on the dermatology life quality index with difference of means: unadjusted –0.78, non-parametric test P=.003; adjusted –0.92 (95% CI, –1.48 to –0.37). There were no statistically significant differences between groups in knowledge of hand eczema and skin protection at follow-up.

“Our trial provides evidence that a secondary preventive program of skin care education and individual counseling based on allergy testing is effective,” the researchers concluded. “We suggest that such a preventive program could be implemented in the health care sector if future trials support our findings and cost effectiveness is shown.”